Dental surgeons have 3 possibilities before a dental extraction when the patient is hypo coagulated by an AVK:
stop the treatment, change it by a heparin therapy or change nothing. Risks for the patient are the risk of embolism
and the haemorrhagic risk.
This study simulates the different costs and safety of the extraction of an included tooth according to the protocol
used for management of the oral anticoagulation treatment.
The first option is very dangerous for the patient because of the extremely serious risk of embolism. This option is
not cheaper than the others because of the difficulty to balance the INR after the resumption of the treatment. A
lot of biological exams are necessary. The second option is expensive because of the biological exams and because of the heparin's injection, at home
by a nurse or at hospital. The risk of embolism is also augmented.
The last protocol, to choose if it is possible, is very safe for the patient because there is no higher risk of embolism.
Furthermore, this option is very inexpensive.
So, it seems to be better for the cost and the safety of the patient not to change the anticoagulation treatment.
(Med Buccale Chir Buccale 2009 ; 15 : 17-30).

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